Diabetic Ulcer

[GaryB1263]

I was helping a friend treat an ulcer. The Dr gave Garamycin but it isn't helping. Does anyone know of a better antibiotic cream that is available around Thailand.

Any other advise might be helpful.

[Sheryl]

Is the wound infected or clean? (It ius common for diabetic ulcers, even when clean and dry, to be very slow to heal).

If infected then Silver sulfadiazine is very good - brand names:

Flamazine

Dermazin

Silverderm

Silverol

Silvex

Cannot use if he is allergic to sulfa drugs like Bactrim.

Did the doctor debride the wound? As this is usually necessary as a first step.

Infected diabetic foot ulcers also often require systemic antibiotics.

I don't know what type of doctor he has but it is best if the ulcer is seen by a vascular specialist or podiatrist. Sometimes skin grafting proves necessary.

[GaryB1263]

The ulcer is clean. It does weep a little but no smell. I want to keep after him about this so thanks for the help.

The silver compounds sound like Silvadene. I used that when I got burned. Do these compounds help healing or prevent infection?

[Inepto Cracy]

The one and only cream to zap infections in the bud,instantly is Fucidene.

I am a diabetic with all the attached horries that go with it. Even tiny sores are a life threat. P M me for more info. This is a serious complication. Good fortune.

[Sheryl]

The ulcer is clean. It does weep a little but no smell. I want to keep after him about this so thanks for the help.

The silver compounds sound like Silvadene. I used that when I got burned. Do these compounds help healing or prevent infection?

It is the same as silvadene. Will treat infection if present, and also prevent it. But will not speed up healing except through controlling infection and neither will any other topical anti-infective.

Actually for a clean ulcer the usual management would be just a normal saline dressing and cover with OpSite or something like it (those clear coverings).

Diabetic ulcers heal very slowly due to the poor circulation. Optimal control of blood sugar is very important. Even with that sometimes skin grafts prove necessary.

See http://emedicine.medscape.com/article/460282-treatment#d8

[GaryB1263]

Thank You

[cowboypastor1950]

keep it dry w/ Providine, creams only made mine get infected & stink

can;t get wet or moist

coconut & magnesium oil on leg ulcers

see a podiatrist, thia drs dont have much xperience here

much nfo on net

u have to be diabetic to have these probs, so seek proper help, not GPs

Edited August 22, 2015 by cowboypastor1950

[cowboypastor1950]

mayb there is some help in BKK

try Theptarin Hosp/ endocronology dept

b blsd

[GaryB1263]

The one and only cream to zap infections in the bud,instantly is Fucidene.

I am a diabetic with all the attached horries that go with it. Even tiny sores are a life threat. P M me for more info. This is a serious complication. Good fortune.

I wanted to thank everyone for the advice. He is doing better and the ulcer is about half the size as before. He has lost interest in bars and drinking so things are improving for him.

Thanks again.

[nowretired]

Self treatment of diabetic (foot?) ulcers is very bad idea. Such ulcers are the leading cause of amputation in diabetics.

Your friend needs to first ensure their diabetes is adequately controlled and s/he should be consulting an endocrinologist on a regular basis.

Secondly in regard to the actual ulcer unless there is evidence of cellulitis antibiotics are generally contraindicated and unhelpful The root cause of the ulcer is a poor circulation and the advice of a vascular surgeon should be sought .

There are no "quick fixes" and creams /ointments etc will not , of themselves cure the problem.

Finally if your friend smokes s/he should stop as smoking contributes to the problem